Preoperative Care

Latest Issue of OR Manager
August 2018

Opioid prescriptions drop after orthopedic team changes protocol

Can hospital leaders and surgeons partner to reduce opioid use while maintaining high patient satisfaction scores? Leaders at OSS Orthopaedic Hospital in York, Pennsylvania, answer that question with a yes. Meghan McNelly, PharmD, MHA, FACHE, who was director of pharmacy at OSS when the opioid-reduction project started, says that from…

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By: Cynthia Saver, MS, RN
May 18, 2018
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More cases start on time after nurses change workflow

Among the many variables that influence on-time starts of surgical cases are the arrival times of patients and staff, as well as the verifications and documentation required before patients are brought to the OR. Increasing on-time starts was a key initiative at Fox Chase Cancer Center. By exploring the influences…

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By: Julie Dameus, MBA, BSN, RN
May 18, 2018
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Preop walking test helps predict postop cognitive dysfunction

Editor's Note A simple 6-minute walking test before cardiac surgery helped predict the risk for cognitive issues after surgery, in this study from Japan. A 6-minute walk distance (6MWD) test was performed preoperatively on 181 patients who had nonemergency cardiac surgery. After surgery, 51 patients had postoperative cognitive dysfunction (POCD).…

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By: Judy Mathias
May 14, 2018
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Patient optimization clinic creates a recipe for success

The government and insurance companies have imposed increasing penalties on healthcare facilities in recent years for readmissions. And with good reason: High readmission rates greatly increase costs and sometimes signal poor patient safety practices. In 2015, roughly 2 million patients were readmitted, costing Medicare $27 billion, according to the Centers…

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By: OR Manager
April 18, 2018
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Effect of dedicated OR teams on clinical outcomes in a colorectal ERAS program

Editor's Note Dedicated OR teams for a colorectal Enhanced Recovery after Surgery (ERAS) program at Johns Hopkins Hospital led to anesthesia providers becoming more central to the ERAS network, which increased process measure compliance and improved clinical outcomes in this study. Before the dedicated OR teams were instituted, surgeons were…

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By: Judy Mathias
February 22, 2018
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Short-term weight loss before bariatric surgery linked to better outcomes

Editor's Note Patients who lose some weight before bariatric surgery achieve greater weight loss after surgery, and they have shorter procedures and hospital stays, this study finds. Those (224 patients) who lost 8% of their excess weight by following a 1,200 calorie diet for 4 weeks before their surgeries had…

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By: Judy Mathias
February 7, 2018
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Interdisciplinary program improves outcomes for older surgical patients

Editor's Note In this study, an interdisciplinary program that includes a coordinated approach by healthcare professionals in surgery, geriatrics, and anesthesiology was associated with improved postoperative outcomes for high-risk older patients having elective abdominal surgery. Compared with a control group (143 patients), older patients participating in the Perioperative Optimization of…

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By: Judy Mathias
January 5, 2018
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Preop cognitive screening predicts postop complications in older total joint patients

Editor's Note Poor preoperative cognition, as assessed by preoperative Mini-Cog screening, is prevalent among older total joint patients and predictive of adverse outcomes, including postoperative delirium, longer hospital stay, and greater likelihood of discharge to a place other than home, this study finds. Of 211 patients 65 years of age…

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By: Judy Mathias
November 7, 2017
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Standardized ambulatory surgery protocol reduces postop pain, ED visits

Editor's Note Standardizing clinical processes for outpatient hernia repairs reduced postoperative pain and unplanned returns to the emergency department (ED), finds this study presented October 23 at the American College of Surgeons 2017 Clinical Congress in San Diego. Researchers developed a standardized eight-step protocol that incorporated best practices and enhanced…

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By: Judy Mathias
October 25, 2017
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ACS NSQIP pilot identifies geriatric–specific risk factors that affect surgical outcomes

Editor's Note A new pilot study from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) finds that adding geriatric-specific risk factors to traditional risk factors could significantly improve the ability of surgeons to predict poor surgical outcomes in older patients. The study involved 36,399 older surgical…

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By: Judy Mathias
October 18, 2017
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